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Blue Cross Blue Shield HMO Insurance for Rehab: What You Need to Know

An HMO is the most cost-effective choice for many people seeking rehab for substance abuse or other mental health scenarios. Of the available insurance providers, a popular choice is Blue Cross / Blue Shield HMO insurance for rehab. Blue Cross Blue Shield is a conglomeration of many smaller insurance providers that bring coverage to millions of Americans across the country. Still, there are many things to think about before making Blue Cross Blue Shield your insurance company.

How Does Blue Cross Blue Shield Treat Behavioral Rehabilitation?

If you’re in rehab (or will be entering rehab) for substance abuse or another mental illness, you are covered under the umbrella of behavioral health. This includes the following services:
* Inpatient admissions;
* Intensive outpatient therapy;
* Partial hospitalization;
* Residential care;
* And in extreme cases, Electric Convulsive Therapy.
Under Blue Cross Blue Shield, you will be covered for the gamut of possible rehabilitation options. As medical evidence points toward substance abuse as a serious medical condition, expect to find more physicians and rehabilitation centers that cater to your specific needs.

However, there are limits to an HMO that can make it difficult to get the rehab support you need.

The Limits of an HMO

An HMO, or health maintenance organization, is basically a network of physicians, specialists, pharmacies and facilities in a certain geographical area. If your insurance is HMO-based, that means you must see your primary-care physician to get a referral to a specialist or clinic that also operates within that same HMO. The benefit is a low cost, but it comes with negative aspects as well.

Foremost, you may not have access to the help you need because your HMO may not have an in-network specialist you can see. This could mean you will have to seek care independently, which will cost a lot more. Still, there is a loophole: if your HMO does provide a specialist but that specialist is located too far away for you to travel to, your network will have to cover your out-of-network visitation with another specialist.

Does HMO Rehab Include Detox?

Detoxification can be a long and involved process for many addicts. In these cases, it’s most beneficial to seek inpatient treatment where you are relegated to the facility full-time. Because Blue Cross Blue Shield is such a far-reaching network, there are many psychologists, social workers, nurses and others who work within the HMO. There are also hospital inpatient units and inpatient-based residential treatment centers you can take advantage of for your detox.

Still, since you’re paying for an HMO and not one of the more premium coverage options, the access you have to these centers and experts will depend on your plan’s specific details.

Within Blue Cross Blue Shield, HMO insurance for rehab is easier to obtain than other options, including a PPO or POS. If you have questions about whether or not an HMO is right for you, fill out the form below to get help.

About The Contributor
The editorial staff of Recovery First is comprised of addiction content experts from American Addiction Centers. Our editors and medical reviewers have over a decade of cumulative experience in medical content editing and have reviewed thousands... Read More